1. Field of the Invention
This invention relates to a surgical device, and more particularly to an anastomosis ring insertion device for use in anastomosing tubular body organs in connection with, for example, intestinal surgery.
The subject invention is particularly useful for anastomosing the lower colon, or bowel section, of the intestines, and is inserted transanally through the patient.
After a surgical procedure such as cutting and removing a diseased or cancerous portion of the bowel, the severed ends of the bowel must be anastomosed. Several procedures are available for connecting together two sections of hollow tubular body organs such as the intestines. Known procedures include suturing, stapling or clamping the severed ends together. For example, U.S. Pat. Nos. 4,576,167, No. 4,603,693 and No. 4,646,745 are directed to circular surgical staplers for joining hollow body organs.
Another procedure using anastomosis buttons and clamps is disclosed in U.S. Pat. Nos. 3,771,526, No. 4,055,186 and No. 4,154,241. These devices may utilize inserter rods which are forced upwardly into the rectum through the anus to position one half of a clamp device in the lower colon and engage the other half of the clamp device positioned in the upper colon to draw the two halves together.
Still another procedure involves use of an anastomotic device that is the subject of U.S. Pat. Nos. 4,467,804, No. 4,552,148 and No. 4,766,898, which are assigned to the assignee of the present application, and marketed and sold under the VALTRAC.RTM. trademark. The anastomotic device receives the open ends of two tubular body organs to be anastomosed over a pair of ring members. The ring members have annular connecting means which mate with each other to clamp the body organs contiguous to each other so they can grow and heal together.
The anastomotic device, which will be referred to hereinafter and in its embodiment for use in the intestines as a bowel anastomosis ring, is pictured in FIGS. 12 through 14. A complete anastomosis ring 11 is shown in FIG. 12 and is comprised of two identical unitary members 13 of mushroom cap configuration. FIGS. 13 and I4 show a bottom plan view and top plan view, respectively, of the unitary member. The bottom plan view in FIG. 13 shows a ring member 15 having a pair of diametrically opposed depending legs 17 each supporting a plurality of engaging pawls 19. Alternately positioned between the depending legs and opposite to each other are depending engaging members 21, each of which has a pawl engaging recess 23 to cooperatively receive the pawls when the two unitary members 13 are joined together to form the anastomosis ring. For ease of reference, the ring member will be referred to as the head of the anastomosis ring and the depending legs and engaging members will be referred to as the neck.
FIG. 14 shows the top of the unitary member molded to form four notches 25 and four ridges 27 alternately positioned around its inner periphery.
As shown in FIG. 12, the pawls 19 are positioned on each depending leg 17 such that the unitary members can mate in an engaged position as shown in solid lines, or in a fully closed position as shown in solid and broken lines. A profile of the engaging pawl showing engaging edge 29 and slope 31 can also be seen in FIG. 12.
The unitary members 13 are formed of a bio-absorbable material that permits disintegration of the device in a relatively short periodof time after healing of the tubular body organ ends begins. Acceptable materials for forming the anastomosis rings are disclosed in U.S. Pat. No. 3,297,033 and are referred to as poly-hydroxyacetic ester and lactide copolymers. Molded surgical articles made from a wide variety of glycolide/lactide copolymers are well known in the art.
2. Description of the Prior Art
U.S. Pat. No. 4,667,673, also assigned to the assignee of the present application, discloses an applicator device for mounting and inserting the bowel anastomosis ring described above and a method for using the applicator. The device includes a mounting extension for mounting the two halves of the bowel anastomosis ring and an inserter which may be curved. The inserter portion of the applicator passes through the interior of the rectum and out through the exterior of the anus so that the placement of the bowel anastomosis ring can be done without being exposed to the dirty and contaminated end of the bowel.
As a further improvement in an applicator device for inserting a bowel anastomosis ring, the present invention is directed to a transanal insertion device and provides further advantages for mounting and inserting the bowel anastomosis ring within, for example, the intestines.